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The U.S. Preventive Services Task Force recommends that clinicians adopt universal alcohol screening and brief intervention as a routine preventive service for adults, and efforts are underway to support its widespread dissemination. The likelihood that healthcare systems will sustain this change, once implemented, is under-reported in the literature. This article identifies factors that were important to postimplementation sustainability of an evidence-based practice change to address alcohol misuse that was piloted within three diverse primary care organizations. The Centers for Disease Control and Prevention funded three academic teams to pilot and evaluate implementation of alcohol screening and brief intervention within multiclinic healthcare systems in their respective regions. Following the completion of the pilots, teams used the Program Sustainability Assessment Tool to retrospectively describe and compare differences across eight sustainability domains, identify strengths and potential threats to sustainability, and make recommendations for improvement. Health systems varied across all domains, with greatest differences noted for Program Evaluation, Strategic Planning, and Funding Stability. Lack of funding to sustain practice change, or data monitoring to promote fit and fidelity, was an indication of diminished Organizational Capacity in systems that discontinued the service after the pilot. Early assessment of sustainability factors may identify potential threats that could be addressed prior to, or during implementation to enhance Organizational Capacity. Although this study provides a retrospective assessment conducted by external academic teams, it identifies factors that may be relevant for translating evidence-based behavioral interventions in a way that assures that they are sustained within healthcare systems.

ABSTRACTUnabated mining and utilisation of petroleum and petroleum resources and their conversion to essential fuels and chemicals have drastic environmental consequences, contributing to global warming and climate change. In addition, fossil fuels are finite resources, with a fast-approaching shortage. Accordingly, research efforts are increasingly focusing on developing sustainable alternatives for chemicals and fuels production. In this context, bioprocesses, relying on microorganisms, have gained particular interest. For example, acetogens use the Wood-Ljungdahl pathway to grow on single carbon C1-gases (CO2 and CO) as their sole carbon source and produce valuable products such as acetate or ethanol. These autotrophs can, therefore, be exploited for large-scale fermentation processes to produce industrially relevant chemicals from abundant greenhouse gases. In addition, genetic tools have recently been developed to improve these chassis organisms through synthetic biology approaches. This review will focus on the challenges of genetically and metabolically modifying acetogens. It will first discuss the physical and biochemical obstacles complicating successful DNA transfer in these organisms. Current genetic tools developed for several acetogens, crucial for strain engineering to consolidate and expand their catalogue of products, will then be described. Recent tool applications for metabolic engineering purposes to allow redirection of metabolic fluxes or production of non-native compounds will lastly be covered.

This retrospective study sought to identify a regular pattern of limb bruising which occurs in association with suicidal or accidental hanging. Following exclusion of cases suspicious for homicide, 82 consecutive cases of hanging from a 10-year period were retrospectively reviewed to identify the pattern of traumatic limb injury in each case. Relevant information such as location, toxicology, and type of suspension was also noted. 72% of the reviewed cases had traumatic limb lesions, the majority of which occurred on the posterior upper limb and the anterior lower limb. Although the distribution of limb injury in our study mirrored that found in the literature, the incidence is much higher than in previous studies (7.4-20%). This could either be due to differences in confounding factors such as intoxication and location of hanging or differences in the practice of recording of limb trauma in hanging between centres. Neither type of suspension nor location of hanging were significantly associated with an increased incidence of traumatic limb injury. Positive toxicology was found to increase the likelihood of sustaining limb injury (p = .044084). In conclusion, the presence of this well documented pattern of traumatic limb lesions in cases of hanging should not always raise suspicion of foul play.

Effective waste administration is one of the major environmental issues of the present time. The isolation, taking care of, transportation and transfer of waste is to be appropriately overseen in order to limit the hazard to nature. The efficient estimation of waste is best acknowledged when it is isolated. The customary method for physically isolating the waste uses exertion that is more human, time and cost. This work proposes a waste tracking system with integrated waste sorting mechanism, which is an easy and economical way to segregate and track domestic waste. It is intended to sort the domestic waste into metallic, plastic and glass categories. After segregation, the tracking system informs the server how much waste each household is producing. Along these lines, a successful framework for waste management is made helpful for recycling procedures for better environmental cleaning ecosystem with proper waste management operations.

In view of the realization that fossil fuels reserves are limited, various options of generating energy are being explored. Biological methods for producing fuels such as ethanol, diesel, hydrogen (H2), methane, etc. have the potential to provide a sustainable energy system for the society. Biological H2 production appears to be the most promising as it is non-polluting and can be produced from water and biological wastes. The major limiting factors are low yields, lack of industrially robust organisms, and high cost of feed. Actually, H2 yields are lower than theoretically possible yields of 4 mol/mol of glucose because of the associated fermentation products such as lactic acid, propionic acid and ethanol. The efficiency of energy production can be improved by screening microbial diversity and easily fermentable feed materials. Biowastes can serve as feed for H2 production through a set of microbial consortia: (1) hydrolytic bacteria, (2) H2 producers (dark fermentative and photosynthetic). The efficiency of the bioconversion process may be enhanced further by the production of value added chemicals such as polydroxyalkanoate and anaerobic digestion. Discovery of enormous microbial diversity and sequencing of a wide range of organisms may enable us to realize genetic variability, identify organisms with natural ability to acquire and transmit genes. Such organisms can be exploited through genome shuffling for transgenic expression and efficient generation of clean fuel and other diverse biotechnological applications.

AbstractRiceberry rice has a special characteristic of being specially bred with high nutrients. High-value added products from riceberry are being promoted targeting health-conscious consumers. To provide supporting information for sustainable food systems, environmental footprinting was applied for evaluating the environmental performance of a ready-to-eat product of riceberry rice mixed with kidney red bean called “Riceberry + KU”, developed by Kasetsart University in Thailand. Based on sold unit as the unit of analysis, the carbon footprint of Riceberry + KU was 5.24 gCO2e per 300 g. Interestingly, white rice had the highest carbon footprint and riceberry rice as well as the riceberry product had at least 30% lower values. However, using nutrient-based scores, although white rice still had the highest carbon footprint, Riceberry + KU had 80% lower and the riceberry rice had 65% lower values. This resulted from the highest nutritional levels found in Riceberry + KU along with the lower greenhouse gas emissions from riceberry field during the cultivation stage. Similar trends were found in the other impact categories assessed by using life cycle assessment as well. To provide appropriate information to consumers for making more sustainable food choices, the environmental performance based on nutrient quality resulting from different farming systems and processing methods should be used to derive recommendations for moving toward sustainable food systems. The nutrition-environment nexus assessment could be very useful for supporting consumers toward making more sustainable food choices.

There is abundant evidence that greenhouse gas (GHG) emissions of cereal products, expressed per ton of grain output, have been trending downward over the past 20 years. This has largely been achieved through agricultural intensification that has concurrently increased area-based GHG emissions. The challenge is for agriculture to increase grain yields to meet the food demands of a growing world population while also contributing to climate stabilization goals by reducing net GHG emissions. This study assessed yield-based and area-based emissions and efficiencies for the winter wheat–summer maize (WWSM) rotation system over the period 1996 to 2016 using long-term, longitudinal, farm survey data and detailed soil emission data in Huantai county, Shandong Province, which is an archetype for cereal production across the North China Plain (NCP). In this region, yields have been increasing over time. However, nitrogen fertilizer inputs have decreased substantially with greater adoption of soil nutrient testing. In addition, there has been widespread adoption of residue incorporation into soils. As such, since 2002, the product carbon footprints of wheat and maize have reduced by 25% and 30%, respectively. Meanwhile, area-based carbon footprints for the rotation system have reduced by around 15% over the same period. These findings demonstrate the importance of detailed assessment of soil N2O emissions and rates of soil organic carbon sequestration. They also show the potential for net reductions in GHG emissions in cropping without loss of grain yields.

There is little data delineating relationships between health and worker musculoskeletal symptoms (MSS), particularly among stone, sand, and gravel mine (SSGM) workers. There is also little data detailing the relationships between physical activity and MSS among these workers. A cross-sectional study using data from 459 SSGM workers was completed. Logistic regression analyses assessed relationships between health factors, physical activity, and low back, neck, shoulder, and knee MSS. Those who reported their health as very good/excellent were less likely to suffer low back and knee MSS. Those who indicated their health was poor/fair were more likely to suffer shoulder, neck, and knee MSS. Obese workers were more likely to experience knee MSS and those who smoked in the past had higher odds of neck MSS. Vigorous physical activity was mostly protective, but those performing more than 5 h of moderate physical activity each week had greater odds of shoulder and neck MSS. Given these results, workers in SSGM may benefit from targeted interventions that bolster vigorous physical activity and improve health. Further, health protection efforts need to be initiated by SSGM operations to address work issues and to sustain health as job roles and work hours impacted MSS as well.